Is it low blood sugar or anxiety ? 

The body’s response to low blood sugar and its manifestation of anxiety are two separate things, but they are often confused and closely intertwined. 

Some common side effects that both low blood sugar (hypoglycemia) and anxiety share include sweating, shakiness, irritability, fast or irregular heartbeat, and lightheadedness. 

Low blood sugar typically stems from unhealthy eating habits (consuming high glycemic foods that cause a spike and then drop down in sugars), skipped meals, or from poorly managed diabetes. At Texas Diabetes & Endocrinology, our team of board-certified endocrinology specialists are experts at treating diabetes in all its forms. 

Anxiety is a common mental disorder that can result from a combination of factors like genetics, stress or trauma, and certain medications. Anxiety can also stem from an adverse reaction the body has to its own low blood sugar. 

One of our diabetes specialists, Dr. Lucy Esteve, shares insight on how you can differentiate low blood sugar from anxiety. 

 How can you tell if the symptom is a sign of low blood sugar versus anxiety?

The only way to tell if you truly have low blood sugar is to check your blood sugar level with either a blood glucose meter and perform a fingerstick glucose check, or by wearing a continuous glucose monitor (CGM) which measures interstitial glucose levels continuously over a period of 10 to 14 days.  

When using a glucose monitor, it is important to check this right at the time that you are experiencing symptoms. Hypoglycemia occurs when your blood sugar level drops below 70 milligrams per deciliter (mg/dL) and is considered severe when the level drops below 54 mg/dL.


How should you treat those symptoms? What if you aren’t sure of the cause?

If you detect  low blood sugar at home, you should treat it by consuming fast-acting carbohydrates such as 4 ounces of juice or regular soda, hard candies, or 15 grams of glucose tablets or gel. Follow this up with a long-acting carbohydrate such as a sandwich or biscuit and recheck your blood sugar level within 15 minutes.  Repeat this process until your blood sugar level is back within normal range.

The next step is to see a medical professional (either your primary care provider or an endocrinology specialist) to determine the cause of the low blood sugar.


What could be potential causes of low blood sugar? 

A helpful indicator to determine the cause of your low blood sugar is the timing of these symptoms in relation to food.  

Reactive hypoglycemia (or postprandial hypoglycemia) typically occurs within 3 to 4 hours of eating a meal high in carbohydrates such as pasta, pizza, potatoes, rice, bread or cake.

If you are experiencing low blood sugar symptoms overnight, this is suggestive of fasting hypoglycemia which occurs when the body is unable to maintain blood glucose levels during the fasting state. This can be caused by medications, alcohol, critical illness, liver dysfunction or tumors in the pancreas known as insulinoma. 

Dr. Esteve says that “because the symptoms of low blood sugar and anxiety often overlap, it is important to see a healthcare provider to differentiate these two conditions and to determine the best course of treatment.” 

Preventing Low Blood Sugar

To help prevent low blood sugar that could contribute to bouts of anxiety, whether you are diabetic or not, follow these tips:

  • Eat healthy portions of foods that are high in protein (like chicken, fish, nuts and beans) and non-starchy vegetables like spinach and broccoli
  • Exercise often to keep blood circulating effectively throughout the body and to trigger the release of endorphins or the brain’s feel-good chemical
  • Drink alcohol in moderation or limit it altogether to avoid blood sugar spikes 
  • Take all medications as directed and commit to regular check-up appointments with your primary care physician and specialists 

Contact Us to Help Manage your Diabetes, Osteoporosis and Thyroid Conditions 

If you’d like to schedule an appointment with one of our specialists at Texas Diabetes & Endocrinology and discover how our diabetes services  and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

How to Ease Holiday Travel with Diabetes 

The holiday season is here, and with it comes the excitement of decorating, gift-giving, family, friends, food and possibly travel. While all of these things are what make the holidays the most special time of the year, they can also cause stress for some – especially those living with diabetes.

Holiday food indulgences and travel can be challenging with diabetes if you are not prepared, but they can absolutely be enjoyed if you take the time to plan ahead.

How can I travel during the holidays and still manage my diabetes effectively? 

Here are five tips for holiday travel from our team of board-certified endocrinologists at Texas Diabetes & Endocrinology: 

  • Check in with your physicians and endocrinologist and make sure that all your prescriptions are filled before you leave town.
  • Take care when packing your medications and bring extra supplies to have with you in case of a travel delay or an emergency (insulin, test strips, syringes, batteries for glucose monitors, etc.). If traveling by airplane, stash your medications in a carry-on bag so that they are easily accessible and not stuck in checked luggage if it’s lost.
  • Pack healthy snacks for your journey so that you do not have to rely on airport or rest  stop food that is typically full of added sweeteners, carbs, fats and sodium. Safe options that will help keep blood sugars low include hard-boiled eggs, sliced veggies or fruit, nuts, portable salads with grilled meats, or sandwiches on whole-wheat/low-carb bread or tortillas.
  • Once you have reached your destination, adjust the timing of your medications or injections to fit the new time zone you’ve arrived in, if applicable.  Set alarms for yourself on phones, smartwatches or Ipads so that you do not miss your scheduled dosages while enjoying your holiday activities. 
  • Test often to avoid any serious blood sugar highs or lows. Take into consideration your surroundings also and know that higher altitudes and cooler or warmer temperatures could have an effect on your readings.

Finally, remember to enjoy your trip and special time with family and friends! 

For information on how to safely navigate airport security with diabetes medications and medical supplies, visit the TSA/ U.S. Transportation Security Administration

Try new and festive foods in moderation and practice healthy portion control to avoid overindulging and unexpected spikes. More on smart eating tips for the holidays from TD&E can be found here.

Contact Us to Help Manage your Diabetes, Osteoporosis and Thyroid Conditions 

If you’d like to schedule an appointment with one of our specialists at Texas Diabetes & Endocrinology and discover how our diabetes services  and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

type 1.5 diabetes
What is Type 1.5 Diabetes? 

While many people are familiar with diabetes and know the difference between Type 1 (T1D) and Type 2 (T2D), there may be less recognition surrounding Type 1.5 diabetes. 

Type 1.5 was trending during the summer months when pop star Lance Bass revealed that he was recently diagnosed with it. 

At Texas Diabetes & Endocrinology (TD&E), our team of board-certified endocrinologists treat all forms of diabetes.  

Here’s what you should know about the often misunderstood Type 1.5.

What is Type 1.5 diabetes?

Type 1.5 diabetes is an autoimmune disease, also known as latent autoimmune disease in adults (LADA).  It shares some characteristics of both Type 1 and Type 2 diabetes and typically develops later in adulthood.

Like T1D, with Type 1.5 there is a lack of insulin production, and like T2D, it occurs later in life, not during the early childhood years. 

However unlike T2D, Type 1.5 it stems from an autoimmune reaction in beta cells that gradually weakens the pancreas and diminishes its ability to produce insulin.

Type 1.5 is thought to be triggered by previous damage done to the pancreas, from illness or infection, or from genetics and a family history of other autoimmune disorders. 

What are symptoms of Type 1.5 diabetes? 

Type 1.5 diabetes symptoms can be subtle at first, and they often mirror those of T2D, including:

  • Unexplained weight loss
  • Frequent urination, especially at night
  • Increased thirst or dehydration 
  • Blurred vision 

Those diagnosed with Type 1.5 diabetes typically are not obese or overweight and are usually  over 30 years of age.  

How is Type 1.5 diabetes diagnosed?

Arriving at a Type 1.5 diagnosis may take some time, and your endocrinologist may order additional testing. A definitive diagnosis is usually reached via a combination of fasting glucose tests and other comprehensive blood screenings like antibody testing. 

What is the treatment for Type 1.5 diabetes? 

It is important to realize that a diagnosis of Type 1.5 diabetes is serious (but very manageable), and that if left untreated, your body could fall into a state of diabetic ketoacidosis, or a buildup of dangerous acids in the bloodstream due to a lack of insulin. 

Type 1.5 can be treated with common diabetes medications like Metformin to start, but then supplemental insulin is often needed down the road.  At TD&E, we offer the most current options for convenient insulin delivery, such as insulin pumps. 

We also offer a variety of opportunities for patients to participate in clinical research trials that may enhance your traditional therapies.  We will work with you to establish a personalized treatment plan that best suits your lifestyle so that you can live fully with as little interruption as possible to your daily routine while successfully managing your diabetes.  

Contact Us to Help Manage your Diabetes, Osteoporosis and Thyroid Conditions 

If you’d like to schedule an appointment with one of our specialists at Texas Diabetes & Endocrinology and discover how our diabetes services  and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.  

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

Welcoming Endocrinologist Dr. Lucy Esteve

Texas Diabetes & Endocrinology is thrilled to welcome Dr. Lucy Esteve to our team of board-certified endocrinologists and diabetes experts. She is now seeing patients at our South Austin location. 

Dr. Esteve specializes primarily in diabetes management and cutting-edge treatment technologies, such as wearable smartwatches, for the early detection and prevention of diabetes and related complications. 

She is fluent in multiple languages including French, Italian and Spanish. Her ability to communicate in several languages will be helpful in serving our diverse and multicultural population here in Central Texas. 

She joined TDE most recently from her Endocrinology Research Fellowship at Duke University in Durham, NC. 

Dr. Esteve attended Imperial College London in the U.K. where she obtained a BEng in Biomedical Engineering and a MSc in Immunology. She then completed her medical training at Warwick Medical School in the U.K. followed by her Internal Medicine residency training at UT Health San Antonio, TX. 

She holds certifications from the American Board of Internal Medicine (ABIM) in both Endocrinology and Internal Medicine. 

Dr. Esteve and her family chose to settle down in Austin for its multicultural population, strong art and music scene and great food. She instantly felt like Texas Diabetes would be a great fit for her and is excited to work alongside a well-organized, strong clinical team. 

Getting to Know Dr. Esteve

Why are you passionate about what you do?

Coming from a multicultural background, I feel like I can relate to patients and love creating long- term partnerships where we develop a personalized treatment plan together that works for them!

What are some fun facts you’d like to share?

I am the first physician in my family. My family is originally from Europe, but we are all now proudly American! My mother is an artist and my father an engineer, and they could not be more opposite! I am married with two children. 

How do you spend your free time when not caring for patients?

Outside of clinic, I love swimming, cooking, traveling the world, and watching soccer.  I am also an editor for an online knowledge sharing platform called theMednet.

Please join us in warmly welcoming her to the TD&E family!

Contact Us to Help Manage your Diabetes, Osteoporosis and Thyroid Conditions 

If you’d like to schedule an appointment with Dr. Esteve or one of our specialists at Texas Diabetes & Endocrinology and discover how our diabetes services, heart disease prevention,  and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online.

Don’t forget to follow us on Facebook and Instagram and check back with us each month as we provide you helpful wellness and health information.

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